10岁及以下儿童破伤风抗毒素注射的规范化培训效果

Observation on the effect of standardized training fortetanus antitoxin injection in children aged 10 and below

目的 探讨10岁及以下儿童破伤风抗毒素注射的现况及实施规范化培训的效果。方法 2019年7月根据《中国破伤风免疫预防专家共识》对儿童外伤注射破伤风实施1个月规范化培训;将2018年1月—2019年6月收治的10岁及以下外伤(眼科、口腔科、耳鼻喉科、急诊外科)儿童为对照组,2019年8月—2021年6月收治的10岁及以下儿童为观察组;观察两组破伤风抗毒素使用情况和不良反应。结果 对照组275例儿童均使用破伤风抗毒素或破伤风免疫球蛋白注射,实施脱敏疗法46例(16.70%);观察组188例外伤儿童使用破伤风抗毒素或破伤风免疫球蛋白注射51例(27.13%),实施脱敏疗法3例(5.90%),两组比较差异有统计学意义(χ^(2)=284.616、3.962,P<0.05)。两组均未发生过敏反应,未出现破伤风病例。结论 儿童破伤风抗毒素注射的使用存在不合理性,可能增加注射破伤风抗毒素发生过敏的危险,增加患儿实施脱敏疗法增加的痛苦;通过规范化培训能明显较少破伤风抗毒素不合理的使用。

Objective To investigate the present state of tetanus antitoxin administration in children aged 10 and below and evaluate the impact of standardized training implementation.Method In July 2019,a one-month standardised training program was implemented for tetanus injection administration in children following the Chinese Expert Consensus on Tetanus Immunoprophylaxis.Children aged 10 and below,admitted between January 2018 and June 2019,with traumatic injuries in ophthalmology,stomatology,otorhinolaryngology,and emergency surgery were selected as the control group.The observation group consisted of children aged 10 and below,admitted between August 2019 and June 2021.Tetanus antitoxin use and adverse reactions were observed in both groups.Results A total of 275 children in the control group received tetanus antitoxin or tetanus immunoglobulin injection,and 46 cases(16.70%)received desensitization therapy.In the observation group,51 cases(27.13%)received tetanus antitoxin or tetanus immunoglobulin injection from 188 children with traumatic injuries,and 3 cases(5.90%)received desensitization therapy.The difference between the two groups was statistically significant(χ^(2)=284.616,3.962,P<0.05).Both groups did not experience allergic reactions and there were no cases of tetanus.Conclusions The use of tetanus antitoxin injection in children is unreasonable,which may increase the risk of allergic reactions caused by tetanus antitoxin injection and increase the suffering caused by desensitization therapy in children;standardized training can significantly reduce the unreasonable use of tetanus antitoxin.